Comparison of 3D multi-echo gradient-echo and 2D T2* MR sequences for the detection of arterial thrombus in patients with acute stroke.

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Title:	Comparison of 3D multi-echo gradient-echo and 2D T2* MR sequences for the detection of arterial thrombus in patients with acute stroke.
Authors:	Hodel, Jérôme jerome.hodel@gmail.com, Leclerc, Xavier¹, Khaled, Wassef², Tamazyan, Ruben³, Rodallec, Mathieu², Gerber, Sophie², Blanc, Raphael⁴, Benadjaoud, Mohamed⁵, Lambert, Oriane⁴, Rabrait, Cécile⁶, Zuber, Mathieu³, Rahmouni, Alain⁷, Zins, Marc²
Source:	European Radiology. Mar2014, Vol. 24 Issue 3, p762-769. 8p. 3 Black and White Photographs, 1 Diagram, 1 Chart, 1 Graph.
Subjects:	Magnetic resonance imaging, Thrombosis, Stroke, Arterial occlusions, Angiography
Abstract:	Objectives: We compared a multi-echo gradient-echo magnetic resonance sequence (susceptibility-weighted angiography [SWAN]) with the T2* sequence for the detection of an arterial thrombus in acute ischaemic stroke. Methods: Seventy-four consecutive patients with acute ischaemic stroke were included. Proximal arterial occlusions were diagnosed using time-of-flight (TOF) magnetic resonance angiography (MRA). Two-dimensional (2D) axial reformats from 3D SWAN were generated to match with 2D T2* images. For arterial thrombus detection, each set of MR images (T2, 2D SWAN reformats and 3D multiplanar SWAN images) was examined independently and separately by three observers who assigned the images to one of three categories: (0) absence of thrombus, (1) uncertain thrombus, (2) certain thrombus. Agreement and diagnostic accuracy were calculated. Results: Twenty-four proximal arterial occlusions involving the anterior ( n = 20) or posterior ( n = 4) circulation were found. Inter-observer agreement was moderate using T2 images (κ = 0.58), good using 2D SWAN reformats (κ = 0.83) and excellent using multiplanar SWAN images (κ = 0.90). For the diagnosis of thrombus, T2* images were 54 % sensitive and 86 % specific, 2D SWAN reformats were 83 % sensitive and 94 % specific and SWAN multiplanar analysis was 96 % sensitive and 100 % specific. Conclusions: Three-dimensional SWAN sequence improves the detection of arterial thrombus in patients with acute ischaemic stroke in comparison with the 2D T2* sequence. Key Points: • Multi- echo gradient- echo MR ( e.g. susceptibility- weighted angiograph, [ SWAN]) is increasingly used in neuroradiology. • Compared with conventional T2* sequences, SWAN improves detection of arterial thrombus. • Multiplanar SWAN analysis had the best diagnostic performance for arterial thrombus detection. • Sensitivity was 96 % and specificity 100 %. • Findings support combination of time- of- flight and susceptibility effects in suspected acute stroke. [ABSTRACT FROM AUTHOR]
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Database:	Engineering Source

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Abstract:	Objectives: We compared a multi-echo gradient-echo magnetic resonance sequence (susceptibility-weighted angiography [SWAN]) with the T2* sequence for the detection of an arterial thrombus in acute ischaemic stroke. Methods: Seventy-four consecutive patients with acute ischaemic stroke were included. Proximal arterial occlusions were diagnosed using time-of-flight (TOF) magnetic resonance angiography (MRA). Two-dimensional (2D) axial reformats from 3D SWAN were generated to match with 2D T2* images. For arterial thrombus detection, each set of MR images (T2, 2D SWAN reformats and 3D multiplanar SWAN images) was examined independently and separately by three observers who assigned the images to one of three categories: (0) absence of thrombus, (1) uncertain thrombus, (2) certain thrombus. Agreement and diagnostic accuracy were calculated. Results: Twenty-four proximal arterial occlusions involving the anterior ( n = 20) or posterior ( n = 4) circulation were found. Inter-observer agreement was moderate using T2 images (κ = 0.58), good using 2D SWAN reformats (κ = 0.83) and excellent using multiplanar SWAN images (κ = 0.90). For the diagnosis of thrombus, T2* images were 54 % sensitive and 86 % specific, 2D SWAN reformats were 83 % sensitive and 94 % specific and SWAN multiplanar analysis was 96 % sensitive and 100 % specific. Conclusions: Three-dimensional SWAN sequence improves the detection of arterial thrombus in patients with acute ischaemic stroke in comparison with the 2D T2* sequence. Key Points: • Multi- echo gradient- echo MR ( e.g. susceptibility- weighted angiograph, [ SWAN]) is increasingly used in neuroradiology. • Compared with conventional T2* sequences, SWAN improves detection of arterial thrombus. • Multiplanar SWAN analysis had the best diagnostic performance for arterial thrombus detection. • Sensitivity was 96 % and specificity 100 %. • Findings support combination of time- of- flight and susceptibility effects in suspected acute stroke. [ABSTRACT FROM AUTHOR]
ISSN:	09387994
DOI:	10.1007/s00330-013-3061-1